Endodontic Retreatment

With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed.

As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:

Narrow or curved canals were not treated during the initial procedure.

  • Complicated canal anatomy went undetected in the first procedure.
  • The placement of the crown or other restoration was delayed following the endodontic treatment.
  • The restoration did not prevent salivary contamination to the inside of the tooth.

In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:

  • New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
  • A loose, cracked or broken crown or filling can expose the tooth to a new infection.
  • A tooth sustains a fracture.

What will happen during retreatment?

  1. The endodontist will discuss your treatment option. If you and your endodontist choose retreatment, the endodontist will reopen your tooth to gain access to the
    root canal filling material. In many cases, complex restorative material – crown,
    post, and core material – must be disassembled and removed to permit access to the root canals.
  2. After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment.
  3. After cleaning the canals, the endodontist will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This surgery involves making an incision to allow the tip of the root to be sealed.
  4. After your endodontist completes retreatment, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to full function.

**Information obtained from American Association of Endodontists. All rights reserved. For more on this and other Endodontic topics please see www.aae.org.

An illustration of new root filling material placed into a tooth's canals
Root Material Placed
An example of a tooth's filling restored by new root canal filling
Filling Restored
A representation of a fully healed tooth by new root canal filling placed
Healed Tooth

In some cases, new problems can influence a tooth that was successfully treated:

  • New decay can expose a root canal filling material, causing infection.
  • A cracked or loose filling or crown can expose the tooth to new infection.

Once retreatment has been selected as a solution to your problem, the doctors will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. The doctors will now clean your canals and carefully examine the inside of the problematic tooth. Once cleaned, the doctors will fill and seal the canals and place a temporary filling in the tooth.

At this point, you will need to return to your dentist as soon as possible in order to have a new crown or restoration placed on the tooth to restore full functionality.